Title
a. Authorize the Director of Health Services, or designee to sign a Standard Agreement (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) to provide legal services to patients of the Clinic Services Bureau to address social determinants of health, for the term July 1, 2024, to June 30, 2025, and an Agreement amount not to exceed $250,000; and
b. Approve the recommendation of the Director of Health Services to approve the following non-standard risk provisions regarding indemnification and business automobile liability insurance; and
c. Authorize the Director of Health Services or designee to sign up to three (3) future amendments that do not significantly change the scope of work and do not exceed 10% ($25,000) of the total Agreement amount, for a revised total liability of $275,000.
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
a. Authorize the Director of Health Services, or designee to sign a Standard Agreement (“Agreement”) with California Rural Legal Assistance (CRLA) Medical-Legal Partnership (MLP) to provide legal services to patients of the Clinic Services Bureau to address social determinants of health, for the term July 1, 2024, to June 30, 2025, and an Agreement amount not to exceed $250,000; and
b. Approve the recommendation of the Director of Health Services to approve the following non-standard risk provisions regarding indemnification and business automobile liability insurance; and
c. Authorize the Director of Health Services or designee to sign up to three (3) future amendments that do not significantly change the scope of work and do not exceed 10% ($25,000) of the total Agreement amount, for a revised total liability of $275,000.
SUMMARY/DISCUSSION:
The Health Department Clinic Services Bureau (Clinic Services) operates twelve community clinic sites designated as Federally Qualified Health Centers (FQHCs) which provide preventive, primary, and specialty medical care services.
CRLA is a non-profit legal service program with a 58-year history of working with underserved populations. Medical-legal partnership (MLP) is an approach to health that integrates healthcare and legal services to positively impact social challenges that can adversely influence health, commonly called Social Determinants of Health (SDOH). Through the MLP, medical professionals refer patients to legal professionals to provide legal services that can positively impact social determinants of health, including income, housing, education, workplace safety, and physical environment.
CRLA began providing on-site legal services at the Alisal Health Center in December 2017, initially through a Facility Use Agreement, and has since expanded its services to all clinic sites, adding additional CRLA staff to support growing patient caseloads. Services are provided at no cost to patients to help address a wide variety of legal issues facing them which can adversely affect their ability to improve their health and well-being. Referrals are also provided to other legal service organizations for immigration, criminal, and other legal needs. Since December 2017 through December 2023, data shows that 1,036 Clinic Services’ patients have accessed the legal services available to them at no-cost through the MLP.
This work supports the County of Monterey Health Department 2018-2024 Strategic Plan Goal(s): 2) Enhance community health and safety through prevention; and 3) Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. It also supports one or more of the ten essential public health services, specifically: 4) Mobilize community partnerships and action to identify and solve health problems, and 7) Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
County Counsel and the Auditor-Controller have reviewed the Agreement as to legal form and fiscal provisions. The Health Department is requesting modification of the Business Automobile Liability Insurance owned and leased provision and indemnification provision. County Counsel-Risk has reviewed and requests Board approval of the non-standard indemnification and business automobile insurance provisions.
FINANCING:
This Agreement is fully funded with Whole Person Care funds. Since 2020, Clinic Services has provided $941,190 to CRLA for these services with the support of grant funding. Appropriations for this Agreement are included in the Health Department’s (023-4000-8473-HEA017) FY 2024-25 Adopted Budget.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐ Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐ Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒ Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐ Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐ Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Daniel Garcia, Management Analyst I, 796-1293
Approved by:
____________________________Date__________________
Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachment:
Board Report
Standard Agreement